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#1 of 14 Old 01-05-2014, 10:54 AM - Thread Starter
 
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At my birth, I requested to birth my placenta naturally by myself, the last thing I wanted was someone yanking it out of me.... but that's what happened, with a manual extraction (see my birth story).

 

The only reason for cord traction and hurried removal of the placenta would be if it had separated and I was hemorrhaging, or if my uterus had begin to clamp down around it causing trapped placenta. Neither of these things were happening. 

 

What constitutes a postpartum hemorrhage? Is 60 seconds after birth long enough to assess if there is hemorrhage? because it was literally as soon as she was put on my chest I started feeling sharp stabbing pulling pains and I told her to stop-- and she didn't. That's birth rape. Then I had to lay there as she scraped the placenta out of me piece by piece, in immense pain, anxiety and a feeling of being violated- during the time I should have been happy and having floods of good feeling hormones and bonding with my baby. The medical records say "estimated blood loss- 300". From what I've read, that is NOT hemorrhage, which would mean the manual removal was uneccessary. Also- if my uterus was indeed clamping down around it necessitating manual removal, why the heck did they give me an ENTIRE BAG of pitocin? If my uterus was doing the work on its own I wouldn't need it, or maybe they gave me pitocin after she was born and it MADE my uterus do that. 

 

so I guess the questions are:

 

1. Was that a PP hemorrhage

2. Was the ME necessary

3. What can I do about being given pitocin AGAINST my consent for no other reason other than "standard" (eye drops, cutting cord immediately are also standard but I refused those... so why was I not notified that I was given it, when I got there I specifically told everyone NO  pitocin.

4. What can I do about the cord traction/manual removal when I directly said NO.

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#2 of 14 Old 01-05-2014, 09:18 PM - Thread Starter
 
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44 views and no answers?? really?

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#3 of 14 Old 01-05-2014, 10:45 PM
 
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I'm sorry, I wish I could answer your questions. This is beyond my knowledge. I'm sorry you had such a horrible experience.


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#4 of 14 Old 01-05-2014, 11:21 PM
 
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You need to file a formal complaint with the hospital and consider hiring a lawyer. If you have that kind of cash. Also. Complaint against the Des licensee and nurse they have to tell you the mess they are giving you. I'm sorry about what happened. That is not a hemhorage
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#5 of 14 Old 01-06-2014, 01:36 AM
 
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There are a few different definitions of PPH

1. Blood loss of >500ml
2. Blood loss >1000ml
3. Any blood loss, regardless of the amount which causes haemodynamic compromise (heart rate goes up, BP goes down, urine output drops, person feels dizzy or lightheaded)

I can't tell you whether the manual removal was necessary or not. I can tell you that we don't wait until a person has lost 500ml of blood before we start to act. If blood loss appears heavier or more constant (many a woman has had a PPH via slow trickle, it doesn't have to be dramatic gushing) than we consider normal we will look for a cause and treat it. If the placenta is still in the first thing we want to do, usually, is get it out.

All you can do at this point regarding your treatment is make written complaints to the hospital and College of Obstetricians and Gynaecologists. Or, the health care complaints commission if such a thing exists in your state/country.
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#6 of 14 Old 01-06-2014, 07:53 AM
 
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 I'm sorry you had this experience. 

 

I've read your story in other threads and my heart really goes out to you. I had a similar experience and I know how deeply upsetting it can be. In my case, I would have preferred a cesarean to a difficult birth with a large baby and its aftermath, both physical and emotional. It sounds like this is not the case for you, but I am very sorry that you had such a bad experience and also that you went into birth without anyone being truthful and preparing you for the possibility of things being difficult or different from your expectations. It can be really devastating when you feel that you have done everything right and find out that that doesn't guarantee the kind of experience you expected. It sounds like you had heard a lot of positive things about birth and were trying to keep your focus there, but the truth is that a lot of births are far from that ecstatic, blissful ideal. I don't know if it helps much, but I think your birth story is pretty similar to what a lot of women have experienced. You're not alone in this.

 

I'm not a medical professional, but I think your doctor was probably trying to manage the 3rd stage to prevent you losing a great deal of blood. You may have been more at risk for this due to the size of your baby (relative to you) and to the length and difficulty of the delivery. I wish she had managed to communicate this to you at the time or had been able to explain it to you afterward so that you wouldn't feel so violated by what happened. 

 

Again, I'm very sorry you had this experience. I hope you find peace and healing--please don't hesitate to seek counseling or other help if the feelings are overwhelming or you have trouble moving on from the experience. I noticed on the other thread that you were really beating yourself up about deciding to transfer. Please let this line of thinking go--you did what you needed to do at the time in a difficult situation and you should feel pride and not shame for this. Keep in mind that you can't know the outcome if you hadn't transferred then; perhaps things would have been better, but likely not, and it's possible they could have been worse. 

 

Best of luck to you. 

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#7 of 14 Old 01-07-2014, 11:43 AM
 
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Oh this sounds awful and it doesn't sound right to me at all. The placenta will come on its own. I don't understand why they need to rush it out. Not saying there's never any reason, but generally I think leaving it to naturally come out is best. I had an unassisted birth a couple weeks ago and waited for it to come out. Only took a few minutes and I was contracting again. I stood up, gave a good push(my placenta was huge!) And it just plopped right out in one piece...I have read that pulling the placenta out too early can cause hemorrhage itself....I would file a complaint. Sorry you had to go through this
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#8 of 14 Old 01-07-2014, 08:16 PM
 
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I'm not sure if the manual extraction was necessary, but I do know that I lost about 350 CCs within seconds after my third baby's birth and my midwife was pretty anxious to get that placenta out. In my case the placenta detatched immediately, hence the bleeding. The midwife did pull it out though (I didn't push).
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#9 of 14 Old 04-26-2014, 09:56 PM
 
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So to try to answer your questions a bit, I think part of it is defining terms. Did you use the phrase "birth the placenta myself" or "no cord traction?" Cord traction is having a light downward pressure on the cord- not yanking on it, but it would look probably similar on video. The WHO recommends cord traction while awaiting separation of the placenta as it has been shown to reduce PPH. "Birth the placenta myself" is vague enough that the OB wouldn't consider cord traction to violate that. Not that she listened to you anyways, and of course manual removal is clearly not birthing the placenta yourself. The bag of pitocin is a standard dose, same as if you got just 1 muscle shot of it or whatever other similar drug- it's a whole bag I guess b/c it's replacing blood volume too. It's also a WHO recommendation. Unfortunately a verbal 'no' probably doesn't stand up well against a written 'consent to treat' you signed on admission (I'm assuming, but probably you did). The vit k etc is non-emergent so easier to decline but the OB can very easily describe everything she did as emergent ly necessary- in some cases, this course of events is the exactly appropriate treatment. I don't know if that's the case for you, but it sounds like you know that it was not appropriate. Which means that your last question, what can you do about it... Probably nothing against the OB etc but a lot for you- healing and finding a more supportive and caring Provider in the future.
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#10 of 14 Old 04-27-2014, 01:01 PM
 
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I can't answer the question about why you got IV pitocin. But where I live, it's standard protocol to give a single intramuscular dose of pitocin after the birth of the baby, before birth of the placenta.  My midwife told me it reduces chances of PP hemorrhage,  If you said no pitocin, they may have interpreted that as no pitocin during labour and delivery of the baby.  I wonder if they gave it IV to get it into your blood stream faster thinking is would help slow the bleeding? 

 

For my birth plan I OK'd the dose of placental delivery intramuscular pit, but was adamant I didn't get any before that.

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#11 of 14 Old 04-27-2014, 08:19 PM
 
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It is a pretty basic standard of care to give IV syntocinon in the case of a PPH. We give it IV because it acts faster, can be titrated to blood loss and can be continued for as long as needed.

Saying that you didn't want it IM for delivery of the placenta is one thing but giving it to treat an active PPH is a different scenario. It should be treated differently in the birth plan and by health care providers. They should have explained that to you and sought your specific consent.

ETA - I just reread your OP. 60 seconds can be long enough to diagnose a PPH or potential PPH (as I mentioned in a pp, we don't wait for the 500ml loss before we act). Since your notes say you lost 300ml it's very hard to say whether prompt action prevented a greater loss or whether they jumped the gun. It does seem that they went very quickly to manual removal though. I've been a midwife a long time and I haven't seen many placentas which couldn't be removed with CCT.

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#12 of 14 Old 05-02-2014, 05:20 PM
 
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Have you considered a follow up with the OB/midwife in question to ask them directly?  It might be illuminating.


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#13 of 14 Old 05-18-2014, 08:24 AM - Thread Starter
 
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I did talk to the OB, and she was lying. I have part of it on video, and 2 accounts of what happened from a nurse and my midwife- and what they said compared to what she said (to cover her ass) do not match up. 

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#14 of 14 Old 05-18-2014, 11:04 PM
 
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Get your records.

 

If that is standard operating procedure and standard of care at that hospital and for the local ob/gyn societies, then you will really have no where to go other than to tell the doctor of your outrage and disappointment and to find another doctor. You can tell other expectant moms who may want to avoid the same situation.

 

Time is of the essence in the hospital and they have to get you out of the delivery room or OR so that it can be cleaned up and the next mom can be attended to.

 

I have known of home births in which the mom waits for an hour to deliver the placenta with no problems.

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